Accessing Quality Healthcare Services about United Healthcare Providers in Ohio
Ohio residents have access to quality healthcare services through UnitedHealthcare in Ohio. UnitedHealthcare offers a variety of plans and programs, including Medicaid coverage through the UnitedHealthcare Community Plan. This plan provides coverage for eligible families, pregnant women, infants, children, and young adults, with additional support for individuals with disabilities or special healthcare needs. OhioRISE is another managed care program offered by UnitedHealthcare in Ohio, specifically designed to provide behavioral health services for youth. OhioRISE members have access to in-home and community-based services to address their behavioral health needs.
Key Takeaways:
- Ohio residents can access quality healthcare services through UnitedHealthcare in Ohio.
- The UnitedHealthcare Community Plan provides Medicaid coverage for eligible individuals and families.
- OhioRISE is a managed care program offered by UnitedHealthcare for youth with behavioral health needs.
- OhioRISE members have access to in-home and community-based services.
- UnitedHealthcare is committed to providing comprehensive healthcare coverage in Ohio.
UnitedHealthcare Community Plan in Ohio
The UnitedHealthcare Community Plan in Ohio is available to eligible individuals in a wide range of counties throughout the state. Some of the counties covered include Adams, Allen, Butler, Cuyahoga, Franklin, Hamilton, Summit, and many more.
Members of the UnitedHealthcare Community Plan have the ability to choose a primary care doctor from their network and receive access to additional benefits such as a 24/7 nurse advice hotline, health education materials, and other unique offerings that set this plan apart from others. UnitedHealthcare works with a network of medical providers in Ohio who accept their insurance, ensuring that members have access to quality healthcare services.
If you are a resident of Ohio and looking for healthcare coverage, the UnitedHealthcare Community Plan can be a great option. With a wide coverage area and a network of medical providers, you can be assured that you will receive the care you need when you need it. The additional benefits provided by this plan, such as the nurse advice hotline and health education materials, can further enhance your healthcare experience.
By partnering with UnitedHealthcare, medical providers in Ohio have the opportunity to serve a large population of individuals who are insured under the UnitedHealthcare Community Plan. If you are a healthcare provider in Ohio and accept UnitedHealthcare insurance, you can expand your patient base and contribute to improving access to quality healthcare services for Ohio residents.
OhioRISE Program for Behavioral Health Needs
OhioRISE is a managed care program offered by UnitedHealthcare in Ohio specifically designed to address the behavioral health needs of youth. The program aims to increase access to in-home and community-based healthcare services for OhioRISE members and their families, providing essential support for various systems such as juvenile justice, child protection, developmental disabilities, mental health, addiction, and education.
Eligibility for OhioRISE requires individuals to be enrolled in Ohio Medicaid, be under the age of 21, and meet a functional needs threshold for behavioral health care. The assessment of these needs is determined through the Child and Adolescent Needs and Strengths (CANS) assessment.
OhioRISE focuses on delivering comprehensive and personalized care to youth, ensuring their mental health needs are met in the most supportive and effective manner. By incorporating in-home and community-based services, OhioRISE promotes an integrated approach to care, providing a holistic solution for individuals navigating the challenges of behavioral health.
“OhioRISE strives to create a nurturing environment where youth can thrive and overcome their behavioral health challenges. By offering a range of services and working closely with various systems, we aim to empower individuals and improve their overall well-being.”
Eligibility and Enrollment for Ohio Medicaid and OhioRISE
Eligibility and enrollment for Ohio Medicaid and OhioRISE can be obtained through various channels.
For Ohio Medicaid, individuals can:
- Visit the Ohio Medicaid website
- Call the Medicaid Hotline at 1-800-324-8680
- TTY users should call Ohio Relay at 7-1-1
To enroll in the UnitedHealthcare Community Plan for Ohio Medicaid, individuals can:
- Call the Managed Care Enrollment Center at 1-800-605-3040
- TTY: 1-800-292-3572
For OhioRISE, individuals must:
- Be enrolled in Ohio Medicaid
- Meet the eligibility criteria outlined previously
Eligibility and Enrollment Channels:
| Program | Contact Information |
|---|---|
| Ohio Medicaid |
|
| UnitedHealthcare Community Plan for Ohio Medicaid |
|
Note:
In order to enroll in OhioRISE, individuals must already be enrolled in Ohio Medicaid and meet the specified eligibility criteria.
Resources for Healthcare Providers with UnitedHealthcare
UnitedHealthcare understands the importance of equipping healthcare providers in Ohio with the necessary resources and tools to deliver seamless and efficient care to their patients. Through the UnitedHealthcare Provider Portal, healthcare professionals have access to a secure self-service platform that offers a wide range of functionalities.
Key features of the UnitedHealthcare Provider Portal include:
- Connectivity options: Healthcare providers can easily connect and communicate with UnitedHealthcare, ensuring a streamlined flow of information.
- Eligibility checks: The portal provides real-time eligibility verification, allowing healthcare providers to quickly determine if their patients are covered by UnitedHealthcare.
- Claim management: Healthcare professionals can submit and manage claims online, ensuring efficient processing and reimbursement.
- Prior authorization requests: The portal enables healthcare providers to submit prior authorization requests electronically, simplifying the process and reducing paperwork.
In addition to these core functionalities, the UnitedHealthcare Provider Portal offers healthcare professionals access to a wealth of resources and information. Providers can stay updated on the latest medical policies and guidelines, ensuring that they are delivering evidence-based care. The portal also provides training resources, allowing healthcare professionals to familiarize themselves with the tools and benefit plans offered by UnitedHealthcare.
To cater to the specific needs of different healthcare specialties, UnitedHealthcare offers specialized resources as well:
- Dental care: Healthcare providers can access resources related to dental care through UHCDental.com.
- Vision care: Vision care providers can utilize resources provided by marchvisioncare.com or spectera.com.
- Physical health: UnitedHealthcare offers resources for physical health through Optum Physical Health.
By providing comprehensive resources and tools, UnitedHealthcare empowers healthcare providers in Ohio to deliver high-quality care and enhance patient outcomes.
UnitedHealthcare Provider Contact Information
As healthcare providers working with UnitedHealthcare in Ohio, you have access to a dedicated Provider Call Center. If you have any questions or need assistance, you can reach out to our friendly team at (800) 600-9007 from Monday to Friday, between 8 a.m. to 5 p.m.
For your convenience, we have provided various mailing addresses and fax numbers based on different purposes:
Claims Mailing
| Claims Type | Mailing Address |
|---|---|
| Paper Claims (Medical) | P.O. Box 740800 Atlanta, GA 30374-0800 |
| Paper Claims (Pharmacy) | P.O. Box 52000 Phoenix, AZ 85072-2000 |
Utilization Management Appeals
| Appeals Type | Mailing Address |
|---|---|
| Utilization Management Appeals (Medical & Pharmacy) | Appeals and Grievances P.O. Box 30769 Salt Lake City, UT 84130-0769 |
Claims Appeals
| Appeals Type | Mailing Address |
|---|---|
| Alternate Funding Solutions Appeals | Alternate Funding Appeal and Grievance P.O. Box 80125 Indianapolis, IN 46280 |
| MyCare Ohio Appeals | UnitedHealthcare Appeals and Grievances P.O. Box 696 Indianapolis, IN 46206-0696 |
Appeals or Grievances Specific to MyCare Ohio and Medicare Part D
| Appeals Type | Mailing Address |
|---|---|
| MyCare Ohio & Medicare Part D Grievances | UnitedHealthcare Grievances and Appeals P.O. Box 2870 Scranton, PA 18505-2870 |
Feel free to contact us through the respective channels to ensure smooth communication and prompt resolution of any issues you may encounter.
Conclusion
UnitedHealthcare is dedicated to providing comprehensive healthcare coverage in Ohio through their UnitedHealthcare Community Plan and OhioRISE programs. Members of these programs have the advantage of accessing a network of healthcare providers who accept UnitedHealthcare insurance, which ensures that they can receive high-quality care tailored to their specific needs. Ohio residents can trust UnitedHealthcare to connect them with top-notch healthcare providers and access essential healthcare services.
Furthermore, UnitedHealthcare offers a wide range of resources and tools for healthcare professionals in Ohio. These resources help streamline processes and enable healthcare providers to deliver efficient care to their patients. By leveraging the tools provided by UnitedHealthcare, healthcare professionals can focus on what matters most: providing quality care and improving the well-being of their patients.
With a particular emphasis on behavioral health services through the OhioRISE program, UnitedHealthcare demonstrates their commitment to ensuring that all Ohio residents have access to high-quality healthcare. Their dedication to meeting the needs of individuals with behavioral health conditions sets them apart as a valuable partner in the Ohio healthcare landscape. UnitedHealthcare’s commitment to accessible, quality healthcare makes them the go-to choice for Ohio healthcare providers and residents alike.
